间歇性θ爆发式重复经颅磁刺激对酒精依赖患者认知功能的影响  

Effects of intermittentθpulse transcranial magnetic stimulation on cognitive function in alcohol-dependent patients

作　　者：陈晓帆 石晴 黄赛平 李强[1,2] 罗志红[1,2] 周旭辉 CHEN Xiao-fan;SHI Qing;HUANG Sai-ping;LI Qiang;LUO Zhi-hong;ZHOU Xu-hui(Hunan University of Chinese Medicine,Changsha 410007,China;Hunan Provincial Brain Hospital,Changsha 410007,China)

机构地区：[1]湖南中医药大学临床医学院,长沙410007 [2]湖南省脑科医院,长沙410007

出　　处：《中国药物依赖性杂志》2022年第6期432-436,451,共6页Chinese Journal of Drug Dependence

基　　金：国家重点研发计划(2018YFC1314401);湖南省自然科学基金(2021JJ70013,2021JJ70089);湖南省卫健委科研项目(20200620,202103092373);湖南中医药大学临床医学学科“十三五”科技发展与一流学科建设专项(2091007);湖南省普通高等学校教学改革研究立项项目(HNJG-2018-0316);湖南省脑科医院院级课题(2018D09)。

摘　　要：目的观察探讨间歇性θ爆发式刺激(intermittent theta burst stimulation,iTBS)模式下的重复经颅磁刺激(repeated transcranial magnetic stimulation,r-TMS)对男性酒精依赖患者认知功能的影响。方法选取2020年11月—2021年11月湖南省脑科医院(湖南省第二人民医院)酒瘾网瘾科男性酒精依赖住院患者80例,随机抽样法分为iTBS真刺激组和iTBS伪刺激组各40例。两组在接受常规戒酒治疗的基础上,分别给予左前额叶背外侧皮质(left dorsolateral prefrontal cortex,LDLPFC)iTBS刺激和伪刺激,每天1次,每周5天,连续4周共20次治疗。采用重复性神经心理状态测验量表(RBANS)、Stroop色-词关联测验对两组治疗前后认知功能差异性进行评估。结果经过4周治疗后iTBS真刺激组在RBANS总分高于iTBS伪刺激组(P<0.05),且即刻记忆、视觉广度、注意功能分值高于iTBS伪刺激组(P<0.01或P<0.05)。与iTBS伪刺激组相比,治疗后iTBS真刺激组Stroop测验-色(ST-C)和Stroop测验-色字(ST-CW)的耗时数更短(P<0.01)、ST-C中正确数更高(P<0.01)、ST-C中不正确更低,差异有统计学意义(P<0.01)。治疗期间两组在不良反应方面未见明显差异(P>0.05)。结论iTBS模式下的重复经颅磁刺激治疗可有效改善酒精依赖患者的认知功能,疗效显著,且安全性较好。Objective To investigate the effects of repeated transcranial magnetic stimulation(r-TMS)in intermittent theta burst stimulation(iTBS)on cognitive function in male alcohol dependent patients.Methods From November 2020 to November 2021,80 male patients with alcohol dependence in the Department of Alcohol Addiction and Internet Addiction in Hunan Provincial Brain Hospital(Hunan Second People′s Hospital)were selected,random sampling method was divided into iTBS true stimulation and iTBS pseudo-stimulation of 40 cases in each group.The two groups were given iTBS stimulation and pseudo-stimulation respectively once a day,5 days a week,in total of 20 times for 4 weeks on the basis of conventional alcohol treatment.The cognitive function of the two groups before and after treatment was evaluated with the repetitive neuropsychological state scale(RBANS)and the Stroop color-word association test.Results After 4 weeks of treatment,the total score of iTBS true stimulus group in RBANS was higher than iTBS false stimulus group(P<0.05),and the scores of immediate memory,visual span and attention function were higher than iTBS false stimulus group(P<0.01 or P<0.05).Compared with the iTBS pseudo-stimulus group,after treatment,the duration of Stroop test-color(ST-C)and Stroop test-color(ST-CW)in iTBS true stimulus group was shorter(P<0.01),the correct number in ST-C was higher(P<0.01),and the incorrect number in ST-C was lower,the difference was statistically significant(P<0.01).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion iTBS mode repetitive transcranial magnetic stimulation can effectively improve the cognition of patients with alcohol dependence,and the safety is tolerated.

关 键 词：重复经颅磁刺激 酒精依赖 间歇性θ波脉冲 认知功能 

分 类 号：R749[医药卫生—神经病学与精神病学]